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BMD does not easily predict fracture risk in type 1 diabetes
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Traditional parameters, including bone mineral density, do not easily predict fracture occurrence in middle-aged men and women with type 1 diabetes, according to study findings presented at The American Society for Bone and Mineral Research Annual Meeting.
“Fracture risk in type 1 diabetes is reported to be greater compared with nondiabetic controls,” the researchers wrote. “BMD underestimates the observed fracture rate in individuals with [type 1 diabetes].”
Thomas Neumann, MD, of Jena University Hospital in Germany, and colleagues evaluated 105 adults (52 men; median age, 43.6 years) with type 1 diabetes to determine potential predictors for incident fractures. Follow-up was conducted for 6.9 years.
Among women, BMD decreased at the lumbar spine, femoral neck and total hip, whereas it only decreased at the femoral neck in men. A greater decrease in BMD at the lumbar spine and total hip was only found with women in univariate regression analysis.
Seventeen percent of all participants had at least one new fracture. Peripheral fractures were found in 17, and three had vertebral fractures.
No differences were found between participants with fracture and those without fracture for age and BMD.
The Fracture Risk Assessment Tool evaluating the 10-year risk for major osteoporotic fractures and hip fractures did not identify participants with subsequent fractures.
Higher HbA1c values (P = .043) and lower trabecular bone score (P = .013) at baseline were found in participants with fractures.
“The occurrence of fractures in middle-aged men and women with [type 1 diabetes] is high and not predictable with traditional parameters including BMD,” the researchers wrote. “Only HbA1c and mean [trabecular bone score] are independently associated with incident fractures. Further studies in larger cohorts are needed to test a risk prediction model in [type 1 diabetes].” – by Amber Cox
Reference:
Neumann T, et al. Abstract FR0355. Presented at: The American Society for Bone and Mineral Research Annual Meeting; Oct. 9-12, 2015; Seattle.
Disclosure: Neumann reports no relevant financial disclosures.